Review of Birth Reborn by Michel Odent

I was already a fan of Michel Odent from the many birth videos I have seen him featured on and skim reading this book many years ago.

I thoroughly enjoyed reading his book in its entirety, finding it provides a very holistic picture of how Odent came to be the expert on natural birth that he is regarded today and provides a realistic argument for everything that he does – why minimal intervention is used, how the environment of birth is created and supported and more.

Today Michel Odent is an international famous childbirth pioneer and surgeon who lectures, writes and travels around the world.

Below follows an overview of the book, including some key points of interest and quotes which I am sure will interest fellow HypnoBirthing Practitioners, birth workers, natural birth advocates, mums and pregnant women.

After joining Pithiviers in 1962 as a general surgeon with partial responsibility for the midwifery practice, Odent quickly became more interested and involved in the birthing practices used at the hospital.

He had previously conducted some time in obstetrics as an intern, but felt that most of the expertise at Pithiviers came from the midwife on duty. Through observation he began to notice how a birthing woman’s experience varied quite often with the midwife who supported her depending on their approach to birth.

He began to question midwives as to why they did certain things, with a fully open mind and desire to increase his understanding.

“Before coming to Pithiviers I had known little of the world but doctors and patients. I looked at people from a narrow medical perspective; I had shared the conventional view of childbirth as a medical problem requiring technical solutions.”

“At Pithiviers I became convinced that birth, far from being a medical problem was infact an integral part of our sexual and emotional life.”

Odent talks about how books like Frederic Leboyers “Birth without violence” changed their views on birth, and contributed to the establishment of a more peaceful space in which to birth which was all about creating safety and respect for mum. He notices how immediate contact with mum and babe seemed favourable, and so it was further encouraged. In 1972 he left general surgery to focus solely on obstetrics as he and his team continued exploring the support of women in labour and birth.

Eventually a dedicated birthing room or ‘salle savage” meaning primitive room was designed for improved privacy and comfort of laboring women, providing them an alternative to the traditional delivery bed. He believed this was the first real step in giving birth back to women since 17th century obstetrics first came into being. It is indeed interesting to note the word obstetric comes from latin = ob + stare, meaning to stand before.

Odent continues to discuss the many things Pithiviers use as a standard approach to birth and how in doing so they have been able to restore an approach which ‘de-medicalises’ birth, restoring dignity and humanity and control to the mother, while achieving results that are favourable with the best in the world.

These include a caesarean rate of 7% which is amazing when considered alongside a perinatal mortality rate below 10/1000, and with no screening whatsoever. These statistics provide dramatic evidence that this hands off approach transforms childbirth into a safe alternative.

So what do they do that is achieving these incredible outcomes?

The natural wisdom of birth is respected, and while safety measures are put in place for most women birthing there focus is on letting her body and instincts do the work, stipulating that and she doesn’t have to be taught anything, or rarely interfered with.

“On the day of the birth we encourage women in labour to give in to the experience, to lose control and forget all they have learned. The less a woman has learnt about the ‘right’ way to have a child, the easier it will be for her.”

“What’s more, a woman’s attitude towards pain changes as she becomes increasingly confident of her ability to see herself through the labour.”

Pithiviers offers weekly yoga and singing classes in which pregnant women become familiar with breathing techniques informally, and provide a means for emotional release while cultivating a relaxed community environment. They come to the clinic as little or as often they like, with very little structure to the frequency of visits.

Pithiviers utilises a minimal approach to monitoring in pregnancy, labour and birth. The use of ultrasounds in pregnancy is rare, as is regular blood and urine and other tests. Odent talks about avoiding the use of anything that will create undue stress on the mother but not change the outcome of the pregnancy:

“The use of such supplementary exams only if they have a definite effect on a doctor or pregnant woman’s decisions, leaving very few occasions for use.”

Odent also talks about his concerns with conventional obstetrics, and how the birth itself is often seen as a potential problem. He discusses how acceleration of labour (through breaking membranes or use of sytnocin/pitocin) is rarely desireable nor a good reason to intervene. The dorsal position for birthing has been abandoned in favour of assisted squatting, and finds that assistance via a vaccum extractor is used in only 6% of births.

Pithiviers use caesareans in certain circumstances (pre eclampsia or when an overdue baby is showing signs of fetal distress). Caesareans are very much treated as emergency procedures and even if it is suspected that a caesarean will in the end become necessary, Odent usually prefers to wait for labour to begin spontaneously.

Even women birthing breech babies are given an opportunity to begin or establish labour and if problems don’t arise, she will continue birth her baby from a supported squatting position. In summary;

“we almost always wait for labour to start on its own. If vaginal delivery seems to be difficult we have three techniques at our disposal; Pitocin (rarely), vacuum extraction or epistiotomy (sometimes). If delivery by the vaginal route seems impossible or dangerous, we do not hesitate to perform a cesarean.”

By the 80’s Pithiviers grew from a traditional maternity unit to something of an international childbirth center, a focal point for the growing awareness around the importance of changing birth conditions. Today television crews, midwives and health care professionals visit Pithiviers to talk about their work and learn for what the center offers.

Odent closes his book with a reflection on what makes Pithiviers special and says;

“Pithiviers is more than the sum of its parts. It represents an attitude, a belief in the instinctual potential of human beings, and in the innate knowledge that women bring to childbirth.”

“the local women who have given birth at our clinic refer to our style of doing things as plain common sense. These women find our attitude so obvious that they can’t imagine what so many visitors and film crew are doing here. Their astonishment is worth thinking about.”